The effects of denturism: New Zealand dentists' response to competition

Removable dentures provided by dentists, denturists and laboratory technicians

In several countries removable dentures can be supplied by either dentists or denturists. Dental laboratory technicians, on the other hand, are licensed only to construct dentures on the prescription of a dentist and do not supply dentures directly to patients. This study investigates provision of dentures by dentists, denturists and laboratory technicians to 264 elderly Finnish World War II veterans. The veterans were wearing 454 removable dentures, of which 272 were complete dentures (CD) and 177 were removable partial dentures (RPD). Dentists had supplied one-quarter of the CD and three-quarters of the RPD, denturists had supplied two-thirds of the CD and one-fifth of the RPD, whereas the dental laboratory technicians had supplied the remaining seven per cent of the CD and four per cent of the RPD. Denturists had provided mainly mandibular partial dentures. A high proportion of the RPD provided illegally by denturists were made to oppose CD. The subjects reported that maxillary CD were good or very good more often than mandibular CD and considered more often CD by dentists or denturists good or very good than CD by dental laboratory technicians.

Cooperation and competition between dentists and denturists in Finland

The aim of this study was to investigate cooperation between dentists and denturists in Finland, particularly in relation to perceived competition between the two professions. From a representative sample of 350 private dentists and 253 denturists, 68% returned acceptably filled-in questionnaires dealing with competition and cooperation with other healthcare professionals. Dentists referred their patients significantly (P < 0.001) less often to denturists (26.2%) than denturists did to dentists (94.1%). Those who referred their patients to members of the other profession also received patients from the other profession significantly (P< 0.001) more often than those who did not (60.7% vs 16.7% among dentists; 90.0% vs 44.4% among denturists). Denturists saw themselves as competing with dentists (56.0%) significantly (P< 0.001) more often than dentists did with denturists (29.2%). Dentists practicing in small towns or rural areas cooperated more often with denturists than did those practicing in more urban areas. Among denturists, the likelihood of referring patients to dentists was associated with younger age and fewer clinical working hours. It was concluded that cooperation between dentists and denturists was common. Oral healthcare professionals who referred their patients to the other profession also benefited by receiving more patients on referral from them. Dental services provided by denturists are limited, which may explain their greater willingness to cooperate with dentists.